NPI | 1730717448 |
---|---|
Former Name | JACQUELINE WELLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 16915) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-2686) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2020-03-29 |
Last Update Date | 2024-11-06 |